Psychiatric medications, science, marketing, psychiatry in general, and occasionally clinical psychology. Questioning the role of key opinion leaders and the use of "science" to promote commercial ends rather than the needs of people with mental health concerns.

Tuesday, February 20, 2007

I’m going to dissect some of the British Psychological Society's fitness to practice hearing for Lisa Blakemore-Brown in which a psychiatrist, Dr. Trevor Friedman, attested to Ms. Brown’s psychological well-being (or lack thereof; background here, here, and here).The testimony occurred on July 12, 2006. Note that Patricia Hitchcock was the counsel for the BPS and Lucy MacKinnon represented Ms. Brown.Kirsty Morrison is the clerk.My comments are interspersed with the hearing’s text.

Ms. Morrison (page 2):… Concerns are that the content and tone of correspondence received by the society from Ms Blakemore-Brown in relation to complaints from Mr and Mrs xxxxxxxxxxx, (inaudible) between May 2003 and May 2005, made repeated references to the attempts from various people, including the complainants, to destroy her career, set her up or discredit her as a professional. This raised concerns that Ms Blakemore-Brown had been suffering from (inaudible) illness, which is affecting her ability to practise.”

Nice start, eh? Brown is allegedly suffering from some form of mental illness because she made references to people trying to destroy her career or discredit her.One can only wonder if David Healy is likewise paranoid; after all, he lost a job (which would generally count as an attempt to destroy one’s career) when he spoke out about the relations between the drug industry and psychiatry, and when he discussed some of the untoward side effects of SSRIs.Let’s move on…

Ms Mackinnon (page 101): “…My application, now that he [Dr. Friedman] is here, is that per se perhaps his evidence is inadmissible on various points given that he has not examined my client.”

Yep, that’s right.Blakemore-Brown has never met with Dr. Friedman, yet Friedman still rendered some significant judgments regarding the mental health of Blakemore-Brown, as we’ll see shortly.

Dr. Friedman (page 107): Yes. Well, I mean, I think I was being careful not to make conclusions or a diagnosis from what is available to me.I think I was just commenting on what seemed reasonable in my opinion having reviewed the documents. In fact, it is a very short report because I did not want to make too many suppositions that one could possibly go to. I just wanted to state what I thought was reasonable.

Ms. Hitchcock (108): Can you explain briefly to assist the committee the nature of paranoia and what its impact could be in the circumstances.

Dr. Friedman (108): Well, I suppose -- I mean the term “paranoia” in itself refers to the idea that people are more sensitive to their surroundings and events that occur to them, so they tend to see extra significance and take inference from otherwise innocuous events. Paranoia generally refers to, I suppose, normally thought of in a kind of persecutory sense in believing that events are occurring around one that in some way are there to harm or malign the person. So that is a sense in which I read these documents, I believe with some maligned conspiracy or motives of other people to, in some way, harm or to damage to Ms Blakemore-Brown.

Ms Hitchcock (108): To what extent does it impact on your views that the facts as seen by Ms Blakemore-Brown may be capable of objective proof? Is it important to your concern that they should not be true?

Dr Friedman (108-109): It does not necessarily have to be not true for people to be suffering from a paranoid illness. It is their interpretation and understanding of events that is important. I mean they sometimes are untrue as well which is obviously of significance as well. But it is generally people’s reasonable interpretation of what has occurred. It is the way they interpret events rather than the events themselves.

Hold the train.Seriously, STOP.So even if people really are out to get you, you are paranoid if you believe that people are out to harm you.Apparently the natural response of fear when one is objectively, realistically threatened, is now paranoia.

The transcript goes on to describe a few specific emails and that Blakemore-Brown’s words were “rather odd,” and that there is a “sheer mass and bulk of documents” which Friedman finds unreasonable, and that the relevance of some of the documents is concerning to Friedman.One of Blakemore-Brown’s letters is then described as “very unusual.”Whether the circumstances faced by Blakemore-Brown were “rather odd” or “very unusual” is apparently not a concern for Dr. Friedman. Again, whether one is actually faced with a frightening situation or not is not a concern.

Dr. Friedman (112): If one sees this as a paranoid illness problem then obviously the person who is affected in this way has to somehow explain what is going on. So the only explanation for that person is to believe that all these things must then be part of the conspiracy because if they are not agreeing with her they must be against her. So as it goes on, the British Psychological Society become apart of this maligned conspiracy or plot to do Ms Blakemore-Brown down. Again that seems unlikely to me.

Wow, how confident!The good doctor knows “the only explanation” for her behavior.I was not aware that behavioral science had reached the level where we could offer “the only explanation” for an individual’s behavior.

Dr. Friedman (113): I mean, the other point about these letters is I find them -- you know, if you are trying to make a case and you are trying to explain what is going on and you think something bad has happened, there is a normal professional way of writing about such matters and many of these emails seem rather disjointed and broken up and, you know, incoherent almost to the point, which is unexpected of an intelligent trained person who is used to writing reports about such matters. So that is another point of concern in terms of worrying about Ms Blakemore-Brown’s state of mind.

Let’s presume for a moment that Ms. Blakemore-Brown is correct that people really were out to get her. If this were the case, then apparently she is expected to maintain a stiff upper lip while acting “appropriately” to channel her complaints. If you become upset in your correspondence, that is apparently another sign of (you guessed it) paranoia.

So did Lisa Blakemore-Brown have reason to be legitimately concerned? I have a feeling that this story will continue to unfold and my suspicion is that, indeed, Ms. Blakemore-Brown had plenty of reason to be concerned, even if not every single one of her concerns was 100% valid.

There is much more in the transcript, which you can download here.I hope to have more time to discuss this further. My understanding is that the transcript is legitimate, though the BPS apparently refuses to comment about it.

1 comment:

This is a comment made under another bloggers article posted athttp://psychcentral.com/blog/archives/2007/02/20/the-uks-lisa-blakemore-brown-case/

That blogger has received much criticism in the comment section, and further comments appear to have been blocked. The comment intended for that blog is therefore posted here.

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Dear All,

I was interested to read this article.

I wish to make a few points

1. The transcript was read by me as well :) and I have the full copies as have many other people. The section published was not edited.

2. The Human Rights Act 1998 is something has been enshrined into UK Law. As such Article 10 of the Human Rights Act 1998 is paramount. The US equivalent is the right to freedom of expression.

3. Mental Illness should never be used for someone who is sane. Lisa Blakemore Brown is sane and there is no evidence of mental illness. The stigma of the shroud of mental illness is such that one's credibility is destroyed. Blakemore's GP states she is normal. She therefore cannot claim illness benefit yet the BPS state she has some undefined mental illness. Blakemore is outspoken, on occasion headstrong and extremely logical. Why on earth should a person like her be ostracised in this way. She is either mentally ill or not. There is no in between debate.

4. The data discussed within the BPS hearing is Blakemore's data. As such and by her own request, she wished others to be there with her. She also asked for a public hearing. The BPS wrote to me stating that the hearing was held in private to protect Blakemore's privacy. I believe they had no reasons or argument as to why it should not be held in public.

5. The evidence basis for this case is at best flimsy. It is based on a number of emails cut and pasted ( not even the originals) provided by on Penny Mellor. Penny of course was in a criminal court sometime ago - found guilty and accused of being a " dangerous eccentric" by the judge. I will allow the reader to lead to their own conclusions.

For everyone's information - I do not for one minute believe that I as a sane doctor should have been subjected to a "discreet" inquiry by the General Medical Council's screeners. This was admitted in their memorandum. I am of course no one but a whistleblower with two reports under her belt for raising concerns about the mistreatment of the elderly population in this country. I am also the first person to have beaten our medical regulatory body in a civil case hearing when no less than 26 lawyers told me it was impossible. I am the one who read the law books and did it.

I say this because most will find it interesting that the medical assessors from the GMC are also the assessors of the BPS. Those who are astute will understand the behavioural similarities.

I will say this again - I do not appreciate the tone of the article above [on the other blog not here] which in general accepts the abuse of mental illness. People who have mental illness suffer enough without it being used as method of silencing those who will be controversial and outspoken.

Regards

Dr Rita Pal EditorNHS ExposedVoted in the top 50 UK Times best health websiteswww.nhsexposedblog.blogspot.com

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I'm an academic with a respectable amount of clinical experience and no drug industry funding. Given my lack of time, don't expect multiple daily updates. Certain things about clinical psychology, the drug industry, psychiatry, and academics drive me nuts, and you'll probably pick up on these pet peeves before long...